‘Egregious:’ Officials say California prison transfers, testing may be fueling COVID-19 outbreak
Health officials in Lassen County said state contractors testing for COVID-19 in prisons have been using unreliable methods to collect samples, a misstep that officials worry could have exacerbated an outbreak in the rural California county.
In a letter to the state health department this week, Lassen County’s top health official said the California Department of Corrections and Rehabilitation also has allowed infected nurses to transmit the disease — including to a prison healthcare worker — by not using personal protective equipment properly and monitoring themselves for signs of infection.
Lassen County is home to two state prisons and hundreds of corrections workers who live in Susanville and surrounding areas. An outbreak at California Correctional Center has infected about 500 incarcerated people, according to the state’s latest report. At least 266 inmates have active cases, and at least nine employees there have also contracted the disease.
County officials say the state has repeatedly offloaded inmates from infected prisons into the community before the proper 14-day quarantine period was over, opening yet another door for the virus to find a foothold in the sparsely populated county that for months has prided itself on keeping the virus at bay.
“We find that the actions by the state-run facilities to be egregious,” Barbara Longo, Lassen County’s director of health and social services wrote in her Monday afternoon letter to the California Department of Public Health. “This situation has proven to be incredibly costly to Lassen County Public Health in both time and effort.”
The problems date to a widespread employee testing effort in June, Longo said.
Nurses improperly swabbed prison employees’ tongues and cheeks while collecting samples, the county says. They also did not change their gloves from one person to the next, according to the county.
Lassen County’s health department dispatched a team to the testing site to observe and “provided immediate correction to the testing procedures,” Longo wrote. Still, “inconsistencies” led to inaccurate results.
The county letter asserts that the nurses were working for private company, MiraDx, that the corrections department hired to test employees and inmates.
The company says its staff were not sent to the prison until July 1, after the outbreak began.
MiraDx’s employees are “highly trained” in the swab techniques and the company is “very confident in the swab accuracy, said A.J. Weidhaas, a company spokesman. The company does not conduct tongue or cheek swabs in any testing program “and never has.”
In addition to the potential for infected people to have tested negative for the virus because of the less accurate swabs, the county also has concerns about samples that were unusable altogether. In one cohort, the testing lab tagged approximately 93 samples it couldn’t test because of improper collection, storage and shipping, Longo wrote.
“We are requesting that CDPH evaluate the efficacy and reliability of the lab and ask that you work with CDCR come up with a more effective, safe testing strategy,” Longo wrote.
The state health department did not reply to The Sacramento Bee’s request for comment.
Longo did not return a request for comment Thursday. Richard Egan, a county spokesman, said they don’t know to what extent the alleged testing problems contributed to the spread of the virus. A conference call with the state was planned for Friday afternoon, and he said he was hopeful they could reconcile the concerns.
Contractor ‘very confident’ in testing accuracy
Dana Simas, a CDCR spokeswoman, in a statement responding to questions about Lassen County’s letter, defended the $150 million partnership with MiraDx, one of three vendors conducting mandatory tests on prison employees. The Los Angeles-based company has a history of conducting genetic research and has recently transitioned to COVID-19 testing, according to its website.
“We are very confident that MiraDx is safely and accurately testing CDCR employees,” Weidhaas said.
Simas did not deny Lassen County’s claim that some samples were improperly collected or that the prison system’s testing has led to a discrepancy in the number of COVID-19 cases.
She also did not refute claims that six nurses who traveled to Lassen County and later tested positive for the new coronavirus failed to follow safety protocols and infected a hotel worker and prison healthcare employee — the county said it is still conducting contact tracing to understand who else they might have been exposed.
“CDCR and MiraDx are committed to performing specimen collection in a manner that is consistent with health care and public health guidance,” Simas wrote. “We appreciate our partnership with Lassen County and will continue to work closely with them as we focus on addressing COVID-19 and protecting all those who live and work in our state prisons, and the community at-large.”
Early in the pandemic, the U.S. Centers for Disease Control and Prevention recommended using only nasal swabs for diagnostic testing. It amended that guidance in April and said that oropharyngeal samples were allowed, too.
However, nasal swabs have more recently been shown to be the most accurate testing method, said Nam Tran, an associate clinical professor in UC Davis Health’s department of pathology and laboratory medicine. Tran oversees COVID-19 testing initiatives.
He referenced guidelines from May from the Infectious Disease Society of America that found nasopharyngeal swabs to be accurate in detecting COVID-19 97% of the time, compared to oral swabs at 56%. That’s why UC Davis Health continues to use nasopharyngeal swabs for testing.
“Under perfect conditions, that is still the sample that collects the highest quality of virus,” Tran said Thursday.
Weidhaas, with the testing company, said there were a variety of perspectives about the sensitivity of different swabs. The company’s decision to use oropharyngeal ones stemmed from “the infectious disease experts at the CDC and our own scientific validations, which showed oropharyngeal to be highly sensitive.”
As for inmate releases, Simas said CDCR cannot compel people to isolate upon their legally determined release date. People released from custody who have tested positive or been quarantined because of COVID-19 can complete their isolation in a state-provided hotel room.
Regardless of whether the state was following the best science, the discrepancy in test results and the problematic methods county staff observed are still cause for concern, said David Teeter, chair of the Lassen County Board of Supervisors.
He said state health and prison officials needed to “clean up their act.”
“The poor testing procedures, poor quarantine and shelter-in-place regime for inmates and staff, and the lax release of inmates all create vectors for the spread of the virus,” Teeter told The Bee. “It also endangers my county’s economic health since CDCR is the major reservoir of COVID-19 in the region.”
Prison transfers ‘horribly botched’
The back and forth is also the latest in an ongoing rift between the rural, conservative county that has largely kept the virus at bay and officials in Sacramento whose decisions reportedly contributed to an outbreak that jeopardizes Lassen County’s reopening plan.
Tensions date to June when inmates in Lassen County began testing positive for COVID-19.
Inmates who were transferred from San Quentin State Prison, where the virus was circulating widely, brought the disease into the state facility, Lassen County officials said. State lawmakers in a hearing this month described the transfer to San Quentin as “horribly botched” and were highly critical of the CDCR’s transfer process that relied on tests that were weeks old.
While San Quentin is home to the largest current known incidence of COVID-19, California Correctional Center in Susanville has the third-largest active outbreak in the state, according to CDCR’s online dashboard. At least 498 people have tested positive, with 198 new confirmed cases in the past two weeks.
About one-in-seven California Correctional Center inmates in total have tested positive.
When the outbreak in the prison began, Lassen County had just three other COVD-19 positive residents and just 12 confirmed infections since the pandemic began. The number has since grown to 22 active cases, including the infected prison employees.
No deaths have been reported.
Originally built in 1963, California Correctional Center has four facilities and 18 conservation camps. It houses more than 3,000 minimum and medium-security inmates and serves as a gateway for training and placement into California’s prison wildfire program.
The state’s inmate firefighting program has since been imperiled, The Bee reported this month. Nearly one-third of the state’s 43 inmate fire camps were put on lockdown because of the prison outbreak. That meant only 30 of the state’s 77 inmate crews were available to fight a wildfire in the north state.
This story was originally published July 24, 2020 at 5:00 AM with the headline "‘Egregious:’ Officials say California prison transfers, testing may be fueling COVID-19 outbreak."